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Preoperative statins may improve survival after endovascular aortic repair
In a recent study, only half of patients undergoing abdominal aortic aneurysm repair received preoperative statins, but survival among those who received endovascular aortic repair plus preoperative statins was significantly improved at 1 year compared with those who did not receive statins.
In the population-based study, researchers included 19,323 patients from the 2007 to 2008 MedPAR files who were aged 50 years or older and received nonruptured abdominal aortic aneurysm (AAA) repair. Overall, there were 14,602 endovascular aortic repairs and 4,721 open aortic repairs, and 9,913 (50.3%) patients used statins before the procedure.
Among those who received endovascular aortic repair, researchers reported reduced mortality rates for those who received statins vs. those who did not during the following follow-up periods:
- in-hospital: 1% vs. 1.45% (P = .01);
- 30 days: 1.51% vs. 2.3% (P = .0004);
- 90 days: 3.05% vs. 4.66% (P < .0001); and
- 1 year: 7.91% vs. 11.56% (P < .0001).
However, there were no significant differences in mortality for patients who received open repair with or without preoperative statins at any time point.
After adjusting for age, gender, race, comorbidities and the procedure, preoperative statin use yielded a mortality reduction at 90 days (OR = 0.8; 95% CI, 0.7-0.91) and 1 year (OR = 0.76; 95% CI, 0.69-0.84).
In addition, overall complications were reduced in the endovascular arm for those who received statins vs. those who did not (11.94% vs. 13.12%; P = .03), but not in the open repair arm.
“This analysis has demonstrated the persistent underutilization of statin therapy in the vascular population with only 50% of Medicare patients undergoing AAA repair on preoperative statin therapy,” the researchers wrote. “Further prospective studies are needed to define optimal guidelines for the use of statin therapy in the preoperative period for patients undergoing AAA repair.” – by Brian Ellis
Disclosure: The researchers report no relevant financial disclosures.